Predictors of Disease Recurrence in HPV+ Squamous Cell Carcinoma

Monday, October 13, 2025

2:36 PM - 2:42 PM EDT

Location: 127

Introduction: Human papillomavirus-associated oropharyngeal squamous cell carcinomas (HPV+OPSCC) are increasing in incidence due to lack of screening and suboptimal vaccination efforts. While the prognosis is generally better than their HPV-negative counterpart, many patients suffer disease progression. We sought to identify predictors disease recurrence in patients with HPV+OPSCC.

Methods: Patients with biopsy-proven HPV+OPSCC diagnosed from 2012-2021 at a tertiary academic medical center were enrolled. The demographic, clinical, and survival outcomes were obtained from the electronic medical record. Demographic information was summarized using descriptive statistics. A statistical model using age, sex, tumor stage, treatment, and race/ethnicity was used. Kaplan-Meier tests were conducted for univariate analyses and Cox-Proportional Hazards Regression was used to perform multivariate analysis.

Results: 215 patients with HPV+OPSCC were enrolled. Average time to recurrence was 2.43 years. The most common site of distant metastasis was the lung (n=11, 21.1%). Overall survival was 88.4%. Hispanic or Latino patients had significantly poorer survival than non-Hispanic or Latino patients (p=0.008). Univariate analyses found advanced T-stage, lack of surgical resection, and requiring chemotherapy with primary treatment were predictors of disease recurrence and poorer survival (p < 0.05 for all variables). On multivariate analysis, requiring chemotherapy with primary treatment was the strongest predictor of disease recurrence [HR: 2.100, 95% CI: (1.119, 3.944)], and surgical resection was the strongest protective factor for survival [HR: 0.266, 95% CI: (0.099, 0.713)].

Conclusions: Predictors of disease recurrence and death in HPV+OPSCC patients are advanced T-stage, lack of surgical resection, and requiring chemotherapy during primary treatment. Hispanic or Latino patients also had poorer survival. These findings emphasize the importance of early detection and tailored management and surveillance strategies for these higher-risk patients.

Presenting Author(s)

Ella R. Prebel Jackert, BS

Medical Student
Keck School of Medicine of the University of Southern California
Pasadena, CA, United States

Disclosure information not submitted.

Co-Author(s)

Stephanie Wong, MD

Resident Physician
USC Caruso Department of Otolaryngology - Head and Neck Surgery
South Pasadena, California, United States

Disclosure information not submitted.
Michael J. Zalin, BS

Medical Student
Western University of Health Sciences
Montclair, CA, United States

Disclosure information not submitted.
LT

Liyang Tang, MD

Resident Physician
USC Caruso Department of Otolaryngology - Head and Neck Surgery, United States

Disclosure information not submitted.
DK

Daniel I. Kwon, MD

Associate Professor of Head and Neck Surgery
University of Southern California
Los Angeles, California, United States

Disclosure information not submitted.
Mark S. Swanson, MD

Associate Professor of Otolaryngology
UC Irvine - Department of Otolaryngology
orange, CA, United States

Disclosure information not submitted.
NK

Niels Kokot, MD

USC Caruso Department of Otolaryngology - Head and Neck Surgery, United States

Disclosure information not submitted.
US

Uttam Sinha, MD

USC Caruso Department of Otolaryngology - Head and Neck Surgery, United States

Disclosure information not submitted.

Senior Author(s)

AH

Albert Y. Han, MD, PhD

USC Caruso Department of Otolaryngology - Head and Neck Surgery, United States

Disclosure information not submitted.